The sharing of electronic health records (EHRs) and personal health records (PHRs) can provide many benefits for health care providers and their patients. With the sharing of EHRs and PHRs, health care generally improves. The sharing of EHRs and PHRs leads to complete and accurate information, improved access to such information, and empowerment of the patient, who can take an active role in their health by receiving electronic copies of their medical records. Within a radiological environment, for instance, the Digital Imaging Communications in Medicine (DICOM) standard was developed to promote communication of digital image information. The DICOM standard defines the structure of radiological objects, such as images, reports, measurements and other patient documentation, and the manner in which such radiological objects are exchanged. However, before one can fully reap the benefits of electronically sharing EHRs, any system designed to exchange medical records needs to take into consideration that such records contain highly confidential and sensitive information.
To help protect the highly confidential and sensitive nature of exchanged health information among healthcare participants, the Office of the National Coordinator for Health Information Technology developed the Direct Secure Messaging (Direct) standards. In brief, Direct is a secure electronic communication service by which health care personnel can send authenticated, encrypted health information directly to known, trusted recipients. Direct operates like electronic mail (email) with security features, such as point-to-point encryption.